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Related Experiment Video

Updated: Nov 8, 2025

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

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Atrial fibrillation and left atrial size and function: a Mendelian randomization study.

Yordi J van de Vegte¹, Joylene E Siland¹, Michiel Rienstra¹

¹Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.

Scientific Reports

|April 20, 2021

Summary

Atrial fibrillation (AF) may cause enlarged left atria (LA) and reduced LA function. Genetic analysis suggests AF increases LA size and decreases ejection fraction, with a specific gene variant playing a key role.

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Area of Science:

Cardiology
Genetics
Biomedical Imaging

Background:

Enlarged left atria (LA) are common in atrial fibrillation (AF) patients.
The causal relationship between AF and LA size/function remains debated.
Prior studies suggest a bidirectional relationship between AF and LA remodeling.

Purpose of the Study:

To investigate the causal association between atrial fibrillation (AF) and left atrial (LA) size and function.
To determine if genetic predisposition to AF influences LA dimensions and contractility.
To identify genetic variants contributing to the AF-LA relationship.

Main Methods:

Utilized UK Biobank data with cardiovascular magnetic resonance imaging.
Measured LA maximal volume, minimal volume, stroke volume, and ejection fraction, indexed to body surface area (BSA).
Performed two-sample Mendelian randomization analyses using 84 AF-associated genetic variants in individuals without prevalent AF.

Main Results:

Genetically predicted AF showed a causal effect on BSA-indexed LA maximal volume, LA minimal volume, and LA ejection fraction.
No significant causal association was found between AF and LA stroke volume.
Exclusion of rs67249485 (near PITX2) attenuated the observed causal associations, highlighting its role.

Conclusions:

Atrial fibrillation causally increases left atrial size.
Atrial fibrillation causally decreases left atrial ejection fraction.
The rs67249485 variant near the PITX2 gene is a significant contributor to the AF-associated changes in LA size and function.